Page 1729 - Saunders Comprehensive Review For NCLEX-RN

8. Epistaxis
E. Interventions
1. Goals: To reduce the BP and to prevent or lessen the
extent of organ damage
2. Question the client regarding the signs and symptoms
of hypertension.
3. Obtain the BP 2 or more times on both arms, with the
client supine and standing.
4. Compare the BP with prior documentation.
5. Determine family history of hypertension.
6. Identify current medication therapy.
7. Obtain weight.
8. Evaluate dietary patterns and sodium intake.
9. Assess for visual changes or retinal damage.
10. Assess for cardiovascular changes such as distended
neck veins, increased heart rate, and dysrhythmias.
11. Evaluate chest x-ray for heart enlargement.
12. Assess the neurological system.
13. Evaluate renal function.
14. Evaluate results of diagnostic and laboratory studies.
F. Nonpharmacological interventions
1. Weight reduction, if necessary, or maintenance of ideal
weight
2. Dietary sodium restriction to 2 g daily as prescribed
3. Moderate intake of alcohol and caffeine-containing
products
4. Initiation of a regular exercise program
5. Avoidance of smoking
6. Relaxation techniques and biofeedback therapy
7. Elimination of unnecessary medications that may
contribute to the hypertension
G. Pharmacological interventions
1. Medication therapy is individualized for each client,
and the selection of the medication is based on such
factors as the client’s age, presence of coexisting
conditions, severity of the hypertension, and client’s
preferences.
2. See Chapter 53 for medications to treat hypertension.
H. See Box 52-10 for client education.
XXII. Hypertensive Crisis
A. Description
1. A hypertensive crisis is an acute and life-threatening
condition requiring immediate reduction in BP.
2. Emergency treatment is required, because target organ
damage (brain, heart, kidneys, retina of the eye) can
occur quickly.
3. Death can be caused by stroke, kidney failure, or
cardiac disease.

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